The preprocedural medical evaluation establishes the foundation for the entire perioperative journey. Far beyond a simple procedural clearance step, it serves as the clinical launch point for identifying risk, coordinating care pathways, optimizing patient readiness, and aligning operational decision making before the day of surgery. By approaching procedural readiness through a longitudinal and standardized framework, healthcare organizations can reduce variability, improve communication across care teams, and create safer, more efficient, and better coordinated episodes of care.